Categories of Risk Factors Major independent risk factors

Categories of Risk Factors Major, independent risk factors l Life-habit risk factors l Emerging risk factors l

Life-Habit Risk Factors Obesity (BMI 30) l Physical inactivity l Atherogenic diet l

Emerging Risk Factors l l l Lipoprotein (a) Homocysteine Prothrombotic factors Proinflammatory factors Impaired fasting glucose Subclinical atherosclerosis

Risk Assessment Count major risk factors l l For patients with multiple (2+) risk factors - Perform 10 -year risk assessment For patients with 0– 1 risk factor - 10 year risk assessment not required Most patients have 10 -year risk <10%

Major Risk Factors (Exclusive of LDL Cholesterol) That Modify LDL Goals l l l Cigarette smoking Hypertension (BP 140/90 mm. Hg or on antihypertensive medication) Low HDL cholesterol (<40 mg/d. L)† Family history of premature CHD - CHD in male first degree relative <55 years - CHD in female first degree relative <65 years Age (men 45 years; women 55 years)

Diabetes In ATP III, diabetes is regarded as a CHD risk equivalent

CHD Risk Equivalents Risk for major coronary events equal to that in established CHD l 10 -year risk for hard CHD >20% l

Diabetes as a CHD Risk Equivalent l l 10 -year risk for CHD 20% High mortality with established CHD - High mortality with acute MI - High mortality post acute MI

CHD Risk Equivalents l l l Other clinical forms of atherosclerotic disease (peripheral arterial disease, abdominal aortic aneurysm, and symptomatic carotid artery disease) Diabetes Multiple risk factors that confer a 10 -year risk for CHD >20%